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General NPI Number Information
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NPI Number | 1386096071
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Entity Type | Organization
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Legal Business Name | KENNETH P. MUELLER, PHD
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Dates
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Enumeration Date | 07/06/2016
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Last Update Date | 08/25/2016
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Provider Practice Location Address
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Address Line | 80 EAST 11TH STREET STE 411
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City | NEW YORK
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State | NY
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Zip | 10003-6811
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Country | US
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Telephone | 212-924-3742
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Fax |
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Provider Business Mailing Address
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Address Line | 799 BROADWAY STE 441
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City | NEW YORK
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State | NY
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Zip | 10003-6811
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KENNETH P MUELLER
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Credential | PHD
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Telephone | 212-924-3742
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | PRO016995-1
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License Number State | NY
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